Advanced General Medicine

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

ADVANCED GENERAL MEDICINE

Practice address

1019 E Jersey St
Elizabeth, NJ 07201-5503

Phone

(929) 279-3379

NPI assigned

Mar 15, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Raul E Vasquez Duran, MDNPI 1366971244

Title

Owner

Phone

(908) 440-6395

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Raul Emilio Vasquez Duran, MD

  • Family Medicine Physician
  • Elizabeth, NJ
  • NPI 1366971244
  Medicare reassignment NPD Authorized official
• John Marin

  • Physician Assistant
  • Belleville, NJ
  • NPI 1376948364
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1647302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656460800000",
    "number": "1609524941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 E JERSEY ST",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072015503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 E JERSEY ST",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072015503",
            "telephone_number": "929-279-3379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED GENERAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-15",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A",
        "authorized_official_last_name": "VASQUEZ DURAN",
        "authorized_official_first_name": "RAUL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "908-440-6395",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "adgeneralmedicine.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1019 E Jersey St",
            "city": "Elizabeth",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "072015503",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ursala Adil, MD
• Amal Adnan-Ibrahim
• Kerlandre Adrien, LSW
• Adult Alternative Home Care
• Advanced Dental Center P.a
• Advanced Medical Care Group LLC
• Advanced Professional Healthcare Services, LLC
• Advanced Urology Associates, P.a.
• Advanced Women'S Sonography
• Emil Affsa III, LPC

• Primary Care Clinic/Center in Elizabeth, NJ
• Providers in Elizabeth, NJ by specialty
• Primary Care Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.